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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
51 to 75 of 102 Research Studies DisplayedArmstrong MJ, Gronseth GS, Day GS
Patient stakeholder versus physician preferences regarding amyloid PET testing.
Patient and caregiver perspectives on amyloid positron emission tomography (PET) use are largely unexplored, particularly as compared with clinician views. In this study, the investigators surveyed clinicians, patients, caregivers, and dementia advocates on topics relating to an evidence-based guideline on amyloid PET use. They found that patients and caregivers emphasized the importance of having a dementia diagnosis and placed more value on testing and outcomes for asymptomatic populations than clinicians.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Gronseth GS, Day GS .
Patient stakeholder versus physician preferences regarding amyloid PET testing.
Alzheimer Dis Assoc Disord 2019 Jul-Sep;33(3):246-53. doi: 10.1097/wad.0000000000000311..
Keywords: Shared Decision Making, Dementia, Diagnostic Safety and Quality, Evidence-Based Practice, Guidelines, Imaging, Neurological Disorders, Patient-Centered Outcomes Research, Provider, Provider: Physician
Schiltz NK, Warner DF, Sun J
The influence of multimorbidity on leading causes of death in older adults with cognitive impairment.
The aim of this study was to evaluate the relationship of leading causes of death with gradients of cognitive impairment and multimorbidity. The authors found that multimorbidity was common in the study population. Heart disease was the leading cause in all groups, but with a larger percentage of deaths in the mild and moderate/severe cognitively impaired groups than among the noncognitively impaired. The different "paths" down the regression trees showed that the distribution of causes of death changed with different combinations of multimorbidity.
AHRQ-funded; HS023113.
Citation: Schiltz NK, Warner DF, Sun J .
The influence of multimorbidity on leading causes of death in older adults with cognitive impairment.
J Aging Health 2019 Jul;31(6):1025-42. doi: 10.1177/0898264317751946..
Keywords: Elderly, Dementia, Neurological Disorders, Chronic Conditions, Mortality
Armstrong MJ, Alliance S, Taylor A
End-of-life experiences in dementia with Lewy bodies: qualitative interviews with former caregivers.
This study examined the knowledge of former caregivers of patients with dementia with Lewy bodies (DLB) and the patients’ end of life (EOL) experiences. Telephone interviews were conducted with a total of 30 caregivers and family members of individuals who died with DLB in the last 5 years. The interviews revealed a lack of knowledge regarding what to expect, EOL time course, advance care planning, medications at the end of life, approaching end of life, and the death experience itself.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Alliance S, Taylor A .
End-of-life experiences in dementia with Lewy bodies: qualitative interviews with former caregivers.
PLoS One 2019 May 30;14(5):e0217039. doi: 10.1371/journal.pone.0217039..
Keywords: Palliative Care, Dementia, Neurological Disorders, Caregiving
Albrecht JS, Hanna M, Randall RL
An algorithm to characterize a dementia population by disease subtype.
The purpose of this study was to develop a method of categorizing Alzheimer disease and related dementias (ADRD) cases by subtype and to characterize and compare subtype populations by demographic and other characteristics. Cases of ADRD occurring 2008 to 2014 were identified from the OptumLabs Database a categorization algorithm using temporal sequencing of diagnoses and provider type developed. The algorithm identified six dementia subtypes as well as three additional categories that represent unique diagnostic patterns in the data. The authors conclude that the differences and similarities between these groups provide support for their algorithmic approach and offer a unique insight into ADRD subtype characteristics.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Hanna M, Randall RL .
An algorithm to characterize a dementia population by disease subtype.
An algorithm to characterize a dementia population by disease subtype..
Keywords: Dementia, Neurological Disorders
Hong M, Casado BL, Lee SE
The intention to discuss advance care planning in the context of Alzheimer's disease among Korean Americans.
The authors examined the intention to discuss advance care planning (ACP) for a family member with Alzheimer's disease among Korean Americans. Path analyses were conducted on a cross-sectional convenience sample; age, gender, education, and knowledge about Alzheimer's disease and ACP were included as covariates. From their findings, the authors recommended promoting ACP among this population and designing educational interventions to address positive attitudes and subjective norms toward ACP.
AHRQ-funded; HS022947.
Citation: Hong M, Casado BL, Lee SE .
The intention to discuss advance care planning in the context of Alzheimer's disease among Korean Americans.
Gerontologist 2019 Mar 14;59(2):347-55. doi: 10.1093/geront/gnx211..
Keywords: Elderly, Dementia, Neurological Disorders, Shared Decision Making, Racial and Ethnic Minorities
Simon KC, Yucus C, Castle J
Building of EMR tools to support quality and research in a memory disorders clinic.
This article describes the development of a customized EMR toolkit that standardizes patient data collection with hundreds of discrete fields, supports Best Practices for treating patients with memory disorders, and also supports practice-based research. The toolkit was successfully implemented to support Best Practices in the care of patients with memory disorders. Applications are also discussed. Data collection is ongoing, but the authors anticipate that the toolkit will generate data that allows for descriptive and hypothesis-driven research as well as quality improvement among patients seen in memory clinics.
AHRQ-funded; HS024057.
Citation: Simon KC, Yucus C, Castle J .
Building of EMR tools to support quality and research in a memory disorders clinic.
Front Neurol 2019 Mar 7;10:161. doi: 10.3389/fneur.2019.00161..
Keywords: Dementia, Electronic Health Records (EHRs), Health Information Technology (HIT), Neurological Disorders, Quality of Care, Quality Improvement, Tools & Toolkits
Marcum ZA, Hohl SD, Gray SL
Brain health and dementia prevention: a mixed-method analysis.
This study examined perceptions on the ability to prevent Alzheimer’s disease and related dementias (ADRD) by improving brain health. A web-based survey was conducted on a sample 1661 patients in Washington State from February-March 2018. Most respondents were female, aged 51-70, and white. Most agreed that it may be possible to improve brain health to reduce ADRD risk, one-third lacked confidence that they could take personal action to reduce the risk.
AHRQ-funded; HS022982.
Citation: Marcum ZA, Hohl SD, Gray SL .
Brain health and dementia prevention: a mixed-method analysis.
Am J Health Behav 2019 Mar 1;43(2):300-10. doi: 10.5993/ajhb.43.2.7..
Keywords: Dementia, Neurological Disorders, Prevention
Marcum ZA, Walker RL, Jones BL
Patterns of antihypertensive and statin adherence prior to dementia: findings from the adult changes in thought study.
Using the hypothesis that changes in medication adherence might represent an early sign of cognitive impairment, this study examined antihypertensive and statin adherence trajectories in community-dwelling older adults to compare which went on to develop dementia and which did not. Data from Adult Changes in Thought (ACT), a population-based cohort study, was analyzed; 4368 participants aged 65 years or older who had at least one follow-up visit were selected, included on the basis of whether they were prevalent users of either a statin or antihypertensive medication on the first day of follow up. Research-quality dementia diagnoses were used to identify cases. Non-dementia control visits were matched by age, sex, and study cohort that occurred at similar follow-up time as the selected case dementia onset. The authors conclude that the patterns of medication adherence that emerged may be useful to identify people with higher likelihood of developing dementia.
AHRQ-funded; HS022982.
Citation: Marcum ZA, Walker RL, Jones BL .
Patterns of antihypertensive and statin adherence prior to dementia: findings from the adult changes in thought study.
BMC Geriatr 2019 Feb 14;19(1):41. doi: 10.1186/s12877-019-1058-6..
Keywords: Dementia, Elderly, Medication, Neurological Disorders, Patient Adherence/Compliance
Sterling MR, Jannat-Khah D, Bryan J
The prevalence of cognitive impairment among adults with incident heart failure: the "Reasons for Geographic and Racial Differences in Stroke" (REGARDS) study.
The REGARDS study determined the prevalence of cognitive impairment (CI) among adults aged 45 and older with incident heart failure (HF) in order to improve understanding of cognition in HF. Cognitive function was assessed using the Six-Item Screener, and the prevalence of CI among those with incident HF was compared with the prevalence of CI among a matching cohort without HF. The study results indicated that 14.9 percent of the adults with incident HF had CI, suggesting that the majority of cognitive decline occurs after HF diagnosis. The authors suggest that increased awareness of CI among newly diagnosed patients and ways to mitigate it in the context of HF management are warranted.
AHRQ-funded; HS000066.
Citation: Sterling MR, Jannat-Khah D, Bryan J .
The prevalence of cognitive impairment among adults with incident heart failure: the "Reasons for Geographic and Racial Differences in Stroke" (REGARDS) study.
J Card Fail 2019 Feb;25(2):130-36. doi: 10.1016/j.cardfail.2018.12.006..
Keywords: Cardiovascular Conditions, Dementia, Heart Disease and Health, Neurological Disorders
Gaugler JE, Zmora R, Mitchell LL
Six-month effectiveness of remote activity monitoring for persons living with dementia and their family caregivers: an experimental mixed methods study.
This paper describes a pilot study conducted to evaluate the effectiveness of remote activity monitoring (RAM) for persons living with Alzheimer’s disease or a related dementia (ADRD) and their family caregivers. An experimental mixed methods study of 132 persons living with ADRD was conducted for six months. There were mixed results as the early months spent calibrating and modifying the RAM system was challenging for families. For families who care for ADRD patients with less severe cognitive impairment and difficulty navigating around the most there was a statistically significant increase in competence and self-sufficiency. However, it may not be as effective for patients with more severe cognitive impairment.
AHRQ-funded; HS022836.
Citation: Gaugler JE, Zmora R, Mitchell LL .
Six-month effectiveness of remote activity monitoring for persons living with dementia and their family caregivers: an experimental mixed methods study.
Gerontologist 2019 Jan 9;59(1):78-89. doi: 10.1093/geront/gny078..
Keywords: Caregiving, Dementia, Elderly, Health Information Technology (HIT), Neurological Disorders, Quality of Care, Quality Improvement
Carnahan RM, Daly JM, Minion S
A needs assessment of family physicians to inform development of educational resources on antipsychotic use in dementia.
The authors assessed the needs and preferred resources of Iowa physicians to inform the development of educational resources for best practice dementia care and compared the responses of nursing home medical directors with nonmedical directors. They found that medical directors and nonmedical directors had similar preferences for resources used and information needs, with preference for online resources, pocket guides, a handbook, consulting pharmacists, and facility in-services being the most commonly preferred sources of new information. Medical directors were significantly more aware of the FDA warning on antipsychotic use in dementia and treated more nursing home patients. No differences were observed between groups related to confidence in and use of nondrug strategies instead of antipsychotics to manage behavioral symptoms of dementia.
AHRQ-funded; HS019355.
Citation: Carnahan RM, Daly JM, Minion S .
A needs assessment of family physicians to inform development of educational resources on antipsychotic use in dementia.
J Prim Care Community Health 2019 Jan-Dec;10:2150132719840113. doi: 10.1177/2150132719840113..
Keywords: Education: Continuing Medical Education, Medication, Dementia, Neurological Disorders, Elderly, Evidence-Based Practice, Guidelines, Long-Term Care
Armstrong MJ, Alliance S, Corsentino P
Cause of death and end-of-life experiences in individuals with dementia with Lewy bodies.
Researchers investigate the natural history, cause of death, and end-of-life experiences of individuals diagnosed with dementia with Lewy bodies (DLB). In the 20-question survey, respondents indicated that physicians rarely discussed what to expect at the end of life and that the caregiver usually initiated such conversations. Failure to thrive was the most common cause of death, followed by pneumonia and swallowing difficulties, other medical conditions, and complications from falling. The researchers conclude that the study results highlight a critical need for better prognostic counseling and education for persons and families living with DLB, and they recommended further study.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Alliance S, Corsentino P .
Cause of death and end-of-life experiences in individuals with dementia with Lewy bodies.
J Am Geriatr Soc 2019 Jan;67(1):67-73. doi: 10.1111/jgs.15608..
Keywords: Dementia, Neurological Disorders, Patient Experience, Palliative Care, Mortality, Elderly
McCarron HR, Finlay JM, Sims T
Stakeholder engagement to enhance interventions for family caregivers of people with dementia: a case study of care to plan.
This study discusses a case study that uses a community advisory board (CAB) to help interventions for family caregivers of people with dementia. The intervention used is an online dementia caregiver resource called Care to Plan. Transcripts of seven CAB meetings over a 3-year period were reviewed. They looked at: how meetings were conducted and issues that arose; and Care to Plan improvements, how CAB members provided key stakeholder perspectives that resulted in changes in language, functionality, substance and dissemination.
AHRQ-funded; HS022445.
Citation: McCarron HR, Finlay JM, Sims T .
Stakeholder engagement to enhance interventions for family caregivers of people with dementia: a case study of care to plan.
J Gerontol Soc Work 2019 Jan;62(1):29-47. doi: 10.1080/01634372.2018.1505797..
Keywords: Caregiving, Dementia, Neurological Disorders, Patient and Family Engagement
Marcum ZA, Walker R, Bobb JF
Serum cholesterol and incident Alzheimer's disease: findings from the adult changes in thought study.
The purpose of this prospective population-based cohort study was to evaluate associations between high-density lipoprotein cholesterol (HDL) and non-HDL-C levels at specific ages and subsequent Alzheimer's disease (AD) risk. The investigators concluded that people with low (120 mg/dL) and high (210 mg/dL) non-HDL-C levels during their 60s and 70s had modestly higher risk of AD than those with intermediate (160 mg/dL) levels.
AHRQ-funded; HS022982.
Citation: Marcum ZA, Walker R, Bobb JF .
Serum cholesterol and incident Alzheimer's disease: findings from the adult changes in thought study.
J Am Geriatr Soc 2018 Dec;66(12):2344-52. doi: 10.1111/jgs.15581..
Keywords: Heart Disease and Health, Dementia, Elderly, Risk
Albrecht JS, Hanna M, Kim D
Predicting diagnosis of Alzheimer's disease and related dementias using administrative claims.
The objective of this study is to see if a better predictive model could be created for earlier diagnosis of Alzheimer disease and related dementia (ADRD) using the amount of health care utilization (HCU) in individuals prior to diagnosis. A case-control study was conducted including individuals with and without mild cognitive impairment who were diagnosed between 2011 and 2014. They were matched to controls without ADRD and were able to obtain moderate accuracy.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Hanna M, Kim D .
Predicting diagnosis of Alzheimer's disease and related dementias using administrative claims.
J Manag Care Spec Pharm 2018 Nov;24(11):1138-45. doi: 10.18553/jmcp.2018.24.11.1138..
Keywords: Dementia, Diagnostic Safety and Quality, Neurological Disorders
Albrecht JS, Hanna M, Kim D
Increased health care utilization in dementia subtypes before diagnosis.
The objectives of this study were to identify Alzheimer disease and related dementia (ADRD) subtypes and: (1) characterize all-cause and (2) disease-specific health care utilization (HCU) during the 3 years preceding diagnosis, and (3) determine if HCU varied by ADRD subtype. Among other results, the investigators found that HCU increased over time, was highest in the outpatient setting, and varied by ADRD subtype.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Hanna M, Kim D .
Increased health care utilization in dementia subtypes before diagnosis.
Alzheimer Dis Assoc Disord 2018 Oct-Dec;32(4):326-32. doi: 10.1097/wad.0000000000000277..
Keywords: Dementia, Healthcare Utilization
Joyce NR, McGuire TG, Bartels SJ
The impact of dementia special care units on quality of care: an instrumental variables analysis.
The purpose of this study was to compare the quality of care following admission to a nursing home (NH) with and without a dementia special care unit (SCU) for residents with dementia. The investigators found that facilities with an SCU provided better quality of care as measured by several validated quality indicators. The authors suggested that given the aging population, policies to promote the expansion and use of dementia SCUs may be warranted.
AHRQ-funded; HS022998.
Citation: Joyce NR, McGuire TG, Bartels SJ .
The impact of dementia special care units on quality of care: an instrumental variables analysis.
Health Serv Res 2018 Oct;53(5):3657-79. doi: 10.1111/1475-6773.12867..
Keywords: Dementia, Elderly, Quality of Care, Long-Term Care, Nursing Homes
Lee AK, Rawlings AM, Lee CJ
Severe hypoglycaemia, mild cognitive impairment, dementia and brain volumes in older adults with type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) cohort study.
In this study, the investigators aimed to evaluate the link between severe hypoglycaemia and domain-specific cognitive decline, smaller brain volumes and dementia in adults with type 2 diabetes. The investigators concluded that their results demonstrated a strong link between severe hypoglycaemia and poor cognitive outcomes, suggesting a need for discussion of appropriate diabetes treatments for high-risk older adults.
AHRQ-funded; HS018542.
Citation: Lee AK, Rawlings AM, Lee CJ .
Severe hypoglycaemia, mild cognitive impairment, dementia and brain volumes in older adults with type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) cohort study.
Diabetologia 2018 Sep;61(9):1956-65. doi: 10.1007/s00125-018-4668-1..
Keywords: Dementia, Diabetes, Elderly, Neurological Disorders, Risk
Parker WF, Georges RJ, Gao YN
Association between groundwater lithium and the diagnosis of bipolar disorder and dementia in the United States.
This study examined the association between groundwater lithium and the diagnoses of bipolar disorder and dementia in the United States, with adjustment for local health care resources and demographics. Data on groundwater lithium concentrations was collected by the US Geological Survey, and diagnoses were identified from inpatient hospital, long-term care, and other therapy claims files from several sources. The results of the study indicate that, in spite of the substantial variations in groundwater lithium exposure, no significant association between exposure and the risk of bipolar disorder or dementia after adjustment for county-level demographics and health care resource was found. The authors note that therapeutic lithium doses are orders of magnitude larger than groundwater lithium concentrations, which makes a true causal relationship between groundwater lithium and mental health dubious.
AHRQ-funded; HS000084.
Citation: Parker WF, Georges RJ, Gao YN .
Association between groundwater lithium and the diagnosis of bipolar disorder and dementia in the United States.
JAMA Psychiatry 2018 Jul;75(7):751-54. doi: 10.1001/jamapsychiatry.2018.1020..
Keywords: Dementia, Behavioral Health, Neurological Disorders, Risk
McCreedy E, Loomer L, Palmer JA
Representation in the care planning process for nursing home residents with dementia.
This study examined the participation of residents, family members, or representatives in nursing home (NH) long-term care planning for residents with cognitive impairment. A large for-profit NH system was used to recruit study participants. A sample of 18,552 long-stay NH residents in 2016 were surveyed. Of residents with no cognitive impairment, 8% had family or representative participation in care planning, compared with 26% of residents with severe impairments. Family participation was greater in NHs with more social workers.
AHRQ-funded; HS000011.
Citation: McCreedy E, Loomer L, Palmer JA .
Representation in the care planning process for nursing home residents with dementia.
J Am Med Dir Assoc 2018 May;19(5):415-21. doi: 10.1016/j.jamda.2018.01.004..
Keywords: Dementia, Nursing Homes, Long-Term Care, Patient and Family Engagement, Neurological Disorders
Gilmore-Bykovskyi A, Johnson R, Walljasper L
Underreporting of gender and race/ethnicity differences in NIH-funded dementia caregiver support interventions.
The objective of this study was to determine the inclusion and reporting rates among NIH-funded dementia caregiver support interventions. Findings suggested limited NIH guideline compliance that may reflect a lack of awareness regarding potential gender disparities in caregiving roles. In order to ensure NIH guideline compliance, shared investments from researchers, editors, and reviewers to make certain that group differences are systematically identified and reported are recommended.
AHRQ-funded; HS022548.
Citation: Gilmore-Bykovskyi A, Johnson R, Walljasper L .
Underreporting of gender and race/ethnicity differences in NIH-funded dementia caregiver support interventions.
Am J Alzheimers Dis Other Demen 2018 May;33(3):145-52. doi: 10.1177/1533317517749465..
Keywords: Caregiving, Sex Factors, Racial and Ethnic Minorities, Guidelines, Dementia, Disparities
Callahan CM, Bateman DR, Wang S
State of science: bridging the science-practice gap in aging, dementia and mental health.
This article describes why new models of care in aging, dementia, and mental health diffuse inadequately into the healthcare systems and communities where they might benefit older adults. The investigators review a general framework for the diffusion of innovations and highlight the importance of other features of innovations that deter or facilitate diffusion.
AHRQ-funded; HS024384.
Citation: Callahan CM, Bateman DR, Wang S .
State of science: bridging the science-practice gap in aging, dementia and mental health.
J Am Geriatr Soc 2018 Apr;66(Suppl 1):S28-s35. doi: 10.1111/jgs.15320..
Keywords: Elderly, Dementia, Behavioral Health, Healthcare Delivery, Neurological Disorders, Implementation, Evidence-Based Practice
Agimi Y, Albert SM, Youk AO
AHRQ Author: Steiner CA
Dementia and motor vehicle crash hospitalizations: role of physician reporting laws.
This study sought to determine the effect of physician reporting laws and state licensing requirements on crash hospitalizations among drivers with dementia. It concluded that physician reporting laws, mandated or legally protected, were not associated with a lower likelihood of dementia among crash hospitalized drivers. Vision testing at in-person renewal and in-person renewal requirements were significantly related with a lower prevalence of dementia in hospitalized older drivers.
AHRQ-authored.
Citation: Agimi Y, Albert SM, Youk AO .
Dementia and motor vehicle crash hospitalizations: role of physician reporting laws.
Neurology 2018 Feb 27;90(9):e808-e13. doi: 10.1212/wnl.0000000000005022.
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Keywords: Dementia, Elderly, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Policy
Butler M, McCreedy E, Nelson VA
Does cognitive training prevent cognitive decline?: A systematic review.
This review summarized evidence on the effects of cognitive training on cognitive performance and incident dementia outcomes for adults with normal cognition or mild cognitive impairment (MCI). It concluded that results for populations with MCI suggested no effect of training on performance (low-strength and insufficient evidence). Evidence for prevention of cognitive decline or dementia was insufficient.
AHRQ-funded; 290201500008I.
Citation: Butler M, McCreedy E, Nelson VA .
Does cognitive training prevent cognitive decline?: A systematic review.
Ann Intern Med 2018 Jan 2;168(1):63-68. doi: 10.7326/m17-1531.
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Keywords: Dementia, Evidence-Based Practice, Neurological Disorders, Prevention
Butler M, Nelson VA, Davila H
Over-the-counter supplement interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia: a systematic review.
This review summarizes the evidence on efficacy and harms of over-the-counter (OTC) supplements to prevent or delay cognitive decline, mild cognitive impairment (MCI), or clinical Alzheimer-type dementia in adults with normal cognition or MCI but no dementia diagnosis. It concluded that evidence is insufficient to recommend any OTC supplement for cognitive protection in adults with normal cognition or MCI.
AHRQ-funded; 290201500008I.
Citation: Butler M, Nelson VA, Davila H .
Over-the-counter supplement interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia: a systematic review.
Ann Intern Med 2018 Jan 2;168(1):52-62. doi: 10.7326/m17-1530.
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Keywords: Dementia, Evidence-Based Practice, Prevention, Neurological Disorders